Patient Account Representative II (Remote)

Stanford Health Care; Sacramento (CA); Remote; USD 98,570,000 - 110,949,000; Full time

Job summary

Stanford Health Care is seeking a Patient Account Representative (PAR II) to manage insurance balance claims in Epic. This remote, full-time position supports timely revenue cycle operations through payer follow-up, denial review, and payment posting.

Ideal candidates have at least two years of related experience, a high school diploma, strong communication skills, and basic math proficiency. Knowledge of payer landscapes and confidentiality are essential.

Qualifications

• High school diploma or GED equivalent.
• Two years of related work experience.
• Knowledge of medical billing and accounts receivable processes.

Responsibilities

• Handle accounts receivable collections and payer follow-up.
• Process payer denials and basic appeals.
• Post payments in Epic and reconcile batches.
• Review credit balances and underpayments.
• Perform retroactive eligibility checks and registrations.
• Submit electronic or hardcopy claims to payers.
• Respond to payer requests for records via mail or portals.
• Identify trends and escalate issues as appropriate.

Skills

Professional communication

Payer follow-up

Accounts receivable systems

Medical billing knowledge

Confidentiality

Follow instructions

Team collaboration

Basic mathematics

Education

High school diploma or GED

Tools

Epic

Job description

1.0 FTE Full time Day - 08 Hour R2660658 Remote USA 108530005 Rev Cycle PFS Finance & Revenue Cycle

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.

Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview

The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR works in various capacities to support the primary goal of the business office to resolve of unpaid, underpaid, denied or unresolved patient accounts.

Responsibilities

Depending on the specific team, the PAR's focus may be on a mix of various responsibilities from across the Patient Financial Services (PFS) operations. Responsibilities may include:

• Accounts receivable collections and payer follow-up
• Payer clerical and technical denial review and request processing including basic appeals
• Payment posting and batch reconciliation
• Credit balance review and resolution
• Retroactive eligibility and registration
• Underpayment reconciliation
• Client or other special billing

The PAR II works primarily in Epic, under general supervision, to perform the full range of duties for assigned class. This role requires a strong working knowledge of systems and processes. A PAR II is expected to resolve standard queries and problems independently and works on assignments that are moderately complex in nature where critical thinking is required.

Locations

Stanford Health Care

What You Will Do

• Responding to requests from the payer, such as providing medical records or other documentation either by mail or via payer portals
• Following up on unresolved patient accounts in Epic by contacting the payer by phone or via the portal
• Resolving claim edits
• Reviewing payer variances and pursuing underpayments to payers
• Reviewing and resolving payer rejections, denials, and performing appeals as necessary
• Electronic or hardcopy claims editing and submission to payers
• Recognizing potential trends and escalating them as appropriate
• Posting payments in Epic, as well as related adjustments
• Resolving credit balances
• Completing basic charge corrections

Education Qualifications

• High school diploma or GED equivalent

Experience Qualifications

• Two (2) years of progressively responsible and directly related work experience

Required Knowledge, Skills And Abilities

• Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager
• Can maintain professional communication with various PFS staff, payers, and patients regarding the billing of services.
• Ability to follow oral and written instructions and interpret institutional and other policies accurately
• Ability to communicate clearly and professionally both verbally and in writing
• Ability to maintain confidentiality of sensitive information
• Ability to perform basic mathematics
• Ability to plan, prioritize, and meet deadlines
• Ability to work effectively with individuals at all levels of the organization
• Knowledge of accounts receivable software systems and medical billing operations
• Familiarity with medical reimbursement policies and procedures and medical terminology
• Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or other Commercial insurance

These Principles Apply To ALL Employees

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $34.40 - $38.72 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.